Back in the Game: Inside the Sports Physio Approach to Return to Sport

Our Physiotherapist, Ashleigh Mitchell, is the current team physiotherapist for Camberwell Hockey club, which is the home of multiple National and State representative players and many rising stars. As field hockey is a fast-paced, high-skill sport that demands agility, power, and endurance, there is a large demand on the body and is often reason for many injuries. He role involves not just helping players recover from injury, but enhance their performance, and stay on the field.

In this blog, She’ll share some insights into the most common injuries in field hockey, the physiotherapy strategies we use at Camberwell to support return to sport, and how you can access expert rehabilitation guidance if you’re navigating an injury of your own and returning to your sport of choice.

The Physical Demands of Hockey: A Potential Source of Injury?

Field hockey places considerable physical demands on the body. The sport involves frequent sprinting, cutting, lunging, and prolonged spinal flexion due to the low position players adopt with the stick. These repetitive patterns, coupled with external contact and high training loads, make certain injuries more prevalent.

Most Common Injuries in Field Hockey

According to research by Murtaugh (2001) and more recently by Theilen et al. (2016), field hockey injuries are most commonly musculoskeletal and predominantly occur in the lower limb. Based on my clinical experience at Camberwell, these are the top culprits:

1. Proximal Hamstring Tendinopathy (PHT)

• Often seen in drag flickers and athletes doing repetitive sprint work or lunging drills.

• Research by Goom et al. (2016) emphasises that altered lumbopelvic control and gluteal weakness are common contributors.

2. Ankle Sprains and Chronic Instability

• Rapid changes of direction place stress on the lateral ankle ligaments.

• Fong et al. (2007) highlighted lateral ankle sprains as the most common acute injury in field sports.

3. Patellofemoral Pain Syndrome (PFPS)

• Common in adolescents and female players due to high cumulative load from squatting and lunging.

• A study by Rathleff et al. (2015) confirms the benefit of load management and hip/knee control in rehab.

4. Lumbar Spine Stiffness and Low Back Pain

• Prolonged flexed posture during gameplay contributes to mechanical low back pain and paraspinal stiffness.

• van Hilst et al. (2015) reported lumbar pain as the most common trunk complaint in elite-level field hockey players.

5. Concussions and Head Injuries

• While less frequent, sticks and balls at high speed pose a significant concussion risk. Early identification and return-to-play planning are essential.

• Consensus guidelines from McCrory et al. (2023) support the use of graded return-to-sport protocols post-concussion and as physiotherapist we can play a major role in this.

My Role at Camberwell: More Than Just Rehab

As Camberwell Hockey Club’s physiotherapist, my approach goes beyond simply treating pain. I work closely with athletes, coaches, and support staff to implement evidence-based strategies tailored to each injury and each individual’s goals.

Key Components of My Physiotherapy Role:

🔍 1. Injury Assessment and Diagnosis

• Ensuring an early and efficient diagnosis is essential in sport to make sure that athletes can get the most out of their rehab, return in an appropriate amount of time and return at a high level for the best performance

📈 2. Individualised Rehabilitation Programming

• I develop progressive, criteria-driven return-to-play programs. These involve strength and conditioning, neuromuscular retraining, and sport-specific drills.

  
  

🧠 3. Education and Load Management

• Many overuse injuries stem from poor load progression. We guide players through training volume monitoring using acute:chronic workload principles (Gabbett, 2016) and with effective communication amongst coaches and athletes this can be integral in keeping everyone healthy

🧠 4. Return-to-Performance Testing

• Once pain-free, athletes undergo strength and functional testing to determine readiness for return to competition.This includes hop testing, isokinetic strength assessments, and movement quality screens.

• Also undergoing sports specific movement testing to ensure the athlete can handle the rigours of their sport, once returning to play.

🤝 5. Collaboration with Coaches and Trainers

• We use a multidisciplinary model to track athlete recovery and adjust training demands accordingly.

What Does a Return-to-Sport Pathway Look Like?

Heres an example of the stages you may follow when returning from injury:

Stage 1: Pain and swelling control, gait retraining, and gentle mobility work.

Stage 2: Progressive strengthening, proprioception drills, and light linear running.

Stage 3: Change of direction, plyometrics, and reintegration into modified team drills.

Stage 4: Full return to contact training, match simulation, and game play, provided strength/symmetry benchmarks are met.

This framework is adapted to the athlete’s progress and aligns with current return-to-sport research (Creighton et al., 2010).

Why Book In for your Return to Performance Rehabilitation?

Whether you're a Camberwell player or a weekend warrior dealing with a sports injury, professional guidance makes a measurable difference.

Here’s why booking in with me can accelerate your recovery:

• Accurate Diagnosis: Knowing what you're dealing with from the outset saves time and prevents worsening.

• Structured Rehabilitation: No more guesswork—your program will be tailored and research-informed.

• Return-to-Play Confidence: We don’t just aim for pain-free, we aim for performance-ready.

  
  

Injury is never ideal, but it doesn’t have to derail your season. With targeted rehabilitation, evidence-based strategies, and ongoing support, you can return to the field with more resilience than before. If you’re currently sidelined or just want to optimise your performance and reduce injury risk, I’m here to help.

References

• Cook, J. L., & Purdam, C. R. (2012). Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy. British Journal of Sports Medicine, 46(6), 409–416.

• Fong, D. T., Hong, Y., Chan, L. K., Yung, P. S., & Chan, K. M. (2007). A systematic review on ankle injury and ankle sprain in sports. Sports Medicine, 37(1), 73–94.

• Gabbett, T. J. (2016). The training—injury prevention paradox: Should athletes be training smarter and harder? British Journal of Sports Medicine, 50(5), 273–280.

• Goom, T. S., Malliaras, P., & Reiman, M. P. (2016). Proximal hamstring tendinopathy: clinical aspects of assessment and management. Journal of Orthopaedic & Sports Physical Therapy, 46(6), 483–493.

• McCrory, P., et al. (2023). Consensus statement on concussion in sport—the 6th International Conference. British Journal of Sports Medicine, 57(11), 695–711.

• Murtaugh, K. (2001). Injury patterns among female field hockey players. Medicine and Science in Sports and Exercise, 33(2), 201–207.

• Rathleff, M. S., Rathleff, C. R., Olesen, J. L., et al. (2015). High-load strength training improves outcomes in patients with patellofemoral pain. British Journal of Sports Medicine, 49(19), 1274–1280.

• Theilen, T. M., Mueller-Eising, W., Frosch, K. H., & Grim, C. (2016). Injury data of major international field hockey tournaments. British Journal of Sports Medicine, 50(11), 657–660.

• van Hilst, J., Hilgersom, N. F., Kuilman, M. C., & Tak, I. (2015). Injury characteristics in Dutch elite field hockey: a prospective cohort study. Clinical Journal of Sport Medicine, 25(3), 239–243.